SPEAR: STUDY OF PATIENTS WITH PARA-PNEUMONIC PLEURAL EFFUSION WHO ARE RE-ADMITTED WITHIN 30 DAYS

Abstract

SESSION TITLE: Disorders of the Pleura SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/10/2018 01:00 pm - 02:00 pm PURPOSE: Parapneumonic pleural effusions (PPE) pose a significant risk of morbidity and mortality in patients admitted with pneumonia. There are limited data on readmissions in such patients. Readmission rate is an important healthcare quality metric. We sought to determine the rate of 30-day readmissions following an index admission for PPE and the major causes and in-hospital mortality in such cases. METHODS: This is a retrospective cohort study using the 2014 National Readmission Database (NRD). Adults admitted with a primary diagnosis of pneumonia complicated by pleural effusion were included. Patients with primary diagnosis of lung cancer and heart failure, those who died during index admission and inter-hospital transfers were excluded. ICD 9 codes were used to identify all diagnoses. RESULTS: A total of 10,167 index admissions were identified with primary diagnosis of PPE between January to November of 2014. After excluding 364 patients (3.6%) who died during the index admission, 9803 patients were included in the readmission analysis. Of these, 1,313 (13.4%) were re-admitted within 30 days. The average age of these patients was 68.4 years and half were women. The most common causes of readmission were pneumonia (15.5%) and pleural effusion including empyema (13%). Other causes included sepsis (9.7%), heart failure (7.1%) and respiratory failure (3.9%). The in-hospital mortality was 9%, which is higher compared to the index admission (3.6%). CONCLUSIONS: There is a major risk of 30-day readmissions in patients admitted with PPE. Major causes of readmissions were respiratory including pneumonia and pleural effusion. CLINICAL IMPLICATIONS: There is a need to identify predictors of early re-admission in patients with PPE. DISCLOSURES: No relevant relationships by Karishma Bhatia, source=Web Response No relevant relationships by Sathish Pondaiah, source=Web Response No relevant relationships by Naveen Premnath, source=Web Response No relevant relationships by Adil Shujaat, source=Web Response No relevant relationships by Karan Sud, source=Web Response